{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T15:01:39Z","timestamp":1788188499186,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001459","name":"Ministry of Education (MOE) Tier 1 grant","doi-asserted-by":"publisher","award":["NUHSRO\/2022\/091\/T1\/Seed-Sep\/04"],"award-info":[{"award-number":["NUHSRO\/2022\/091\/T1\/Seed-Sep\/04"]}],"id":[{"id":"10.13039\/501100001459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001459","name":"Ministry of Education (MOE) Tier 1 grant","doi-asserted-by":"publisher","award":["CIRG20nov-0016"],"award-info":[{"award-number":["CIRG20nov-0016"]}],"id":[{"id":"10.13039\/501100001459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001349","name":"National Medical Research Council Singapore, Clinician Scientist-Individual Research Grant","doi-asserted-by":"publisher","award":["NUHSRO\/2022\/091\/T1\/Seed-Sep\/04"],"award-info":[{"award-number":["NUHSRO\/2022\/091\/T1\/Seed-Sep\/04"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001349","name":"National Medical Research Council Singapore, Clinician Scientist-Individual Research Grant","doi-asserted-by":"publisher","award":["CIRG20nov-0016"],"award-info":[{"award-number":["CIRG20nov-0016"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Spinal fusion, a common surgery performed for degenerative lumbar conditions, often uses recombinant human bone morphogenetic protein 2 (rhBMP-2) that is associated with adverse effects. Mesenchymal stromal\/stem cells (MSCs) and their extracellular vesicles (EVs), particularly exosomes, have demonstrated efficacy in bone and cartilage repair. However, the efficacy of MSC exosomes in spinal fusion remains to be ascertained. This study investigates the fusion efficacy of MSC exosomes delivered via an absorbable collagen sponge packed in a poly \u0190-caprolactone tricalcium phosphate (PCL\u2013TCP) scaffold in a rat posterolateral spinal fusion model. Herein, it is shown that a single implantation of exosome-supplemented collagen sponge packed in PCL\u2013TCP scaffold enhanced spinal fusion and improved mechanical stability by inducing bone formation and bridging between the transverse processes, as evidenced by significant improvements in fusion score and rate, bone structural parameters, histology, stiffness, and range of motion. This study demonstrates for the first time that MSC exosomes promote bone formation to enhance spinal fusion and mechanical stability in a rat model, supporting its translational potential for application in spinal fusion.<\/jats:p>","DOI":"10.3390\/cells13090761","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T08:42:57Z","timestamp":1714639377000},"page":"761","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Mesenchymal Stem Cell Exosomes Enhance Posterolateral Spinal Fusion in a Rat Model"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6443-5714","authenticated-orcid":false,"given":"Wing Moon Raymond","family":"Lam","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore"},{"name":"Tissue Engineering Program, Life Sciences Institute, National University of Singapore, 27 Medical Drive, Singapore 117510, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Hai","family":"Zhuo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore"},{"name":"Tissue Engineering Program, Life Sciences Institute, National University of Singapore, 27 Medical Drive, Singapore 117510, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore"},{"name":"Tissue Engineering Program, Life Sciences Institute, National University of Singapore, 27 Medical Drive, Singapore 117510, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore"},{"name":"Tissue Engineering Program, Life Sciences Institute, National University of Singapore, 27 Medical Drive, Singapore 117510, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5752-3297","authenticated-orcid":false,"given":"Sai Kiang","family":"Lim","sequence":"additional","affiliation":[{"name":"Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), 61 Biopolis Drive, Proteos, Singapore 138673, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2012-9835","authenticated-orcid":false,"given":"Hwee Weng Dennis","family":"Hey","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore"},{"name":"Tissue Engineering Program, Life Sciences Institute, National University of Singapore, 27 Medical Drive, Singapore 117510, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9147-6423","authenticated-orcid":false,"given":"Wei Seong","family":"Toh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore"},{"name":"Tissue Engineering Program, Life Sciences Institute, National University of Singapore, 27 Medical Drive, Singapore 117510, Singapore"},{"name":"Integrative Sciences and Engineering Program, NUS Graduate School, National University of Singapore, 21 Lower Kent Ridge Road, Singapore 119077, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1097\/BRS.0000000000002822","article-title":"Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004 to 2015","volume":"44","author":"Martin","year":"2019","journal-title":"Spine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12306-019-00634-x","article-title":"Fusion rate and influence of surgery-related factors in lumbar interbody arthrodesis for degenerative spine diseases: A meta-analysis and systematic review","volume":"104","author":"Formica","year":"2020","journal-title":"Musculoskelet. 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